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Individual

KIMBERLY A. MCKENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2240 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 834-4390
(704) 834-3274
Mailing address
2240 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 834-4390
(704) 834-3274

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5004789
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649583113
NC
01
16854
BCBS NC
NC
01
P01182484
MEDICARE RR
NC
Enumeration date
07/26/2010
Last updated
01/06/2016
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